Telitacicept Combined With Glucocorticoids as Initial Therapy for Moderate <scp>IgA</scp> Vasculitis Nephritis With Concurrent Pulmonary Infection in Children: A Case Report

ABSTRACT Given the pivotal role of galactose‐deficient IgA1 (Gd‐IgA1) in the pathogenesis of IgA Vasculitis Nephritis (IgAV‐N), telitacicept, a dual inhibitor targeting both B lymphocyte stimulator (BLyS) and a proliferation‐inducing ligand (APRIL), represents a promising biologic therapeutic alternative offering safer and more effective options. To our knowledge, this is the first case report describing the feasibility of telitacicept combined with glucocorticoids as initial therapy for pediatric IgAV‐N. A 14‐year‐old male presented with a history of purpura, gross hematuria, nephrotic‐range proteinuria (proteinuria 4100.39 mg/24 h), and impaired renal function (serum creatinine 156.52 μmol/L). Renal biopsy confirmed a diagnosis of moderate IgAV‐N (ISKDC IIIa). The patient also had a concurrent pulmonary infection. To avoid the risk of infection exacerbation and reproductive toxicity associated with conventional immunosuppressive agents, initial therapy was administered as telitacicept combined with glucocorticoids (methylprednisolone). After 3 months, methylprednisolone had been rapidly tapered, renal function normalized, proteinuria stabilized below 500 mg/24 h, and hematuria had resolved. During 1 year of follow‐up, no disease recurrence or deterioration was noted, and no serious infectious events occurred. This case provides preliminary clinical evidence for expanding the indications for telitacicept and optimizing treatment strategies for moderate IgAV‐N.